Life-threatening arrhythmia in patients with suspected acute myocarditis
Background: Patients with acute myocarditis (AM) often undergo prolonged rhythm monitoring due to the risk for life-threatening arrhythmia. Objective: To describe the occurrence, timing and potential early rule-out of life-threatening arrhythmia in patients with AM. Methods: We included consecutive...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352906725001216 |
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| author | Melina Krempke Jasmin Büchel Kseniya Bulatova Gianmarco M. Balestra Philip Haaf Jeanne Pouly Paul Drews Christian Mueller Sven Knecht Patrick Badertscher Felix Mahfoud Michael Kühne Christian Sticherling Philipp Krisai |
| author_facet | Melina Krempke Jasmin Büchel Kseniya Bulatova Gianmarco M. Balestra Philip Haaf Jeanne Pouly Paul Drews Christian Mueller Sven Knecht Patrick Badertscher Felix Mahfoud Michael Kühne Christian Sticherling Philipp Krisai |
| author_sort | Melina Krempke |
| collection | DOAJ |
| description | Background: Patients with acute myocarditis (AM) often undergo prolonged rhythm monitoring due to the risk for life-threatening arrhythmia. Objective: To describe the occurrence, timing and potential early rule-out of life-threatening arrhythmia in patients with AM. Methods: We included consecutive patients with suspected AM admitted to the ICU/IMC for continuous rhythm monitoring into a cohort study. We assessed the incidence and timing of life-threatening arrhythmia (sustained ventricular tachycardia, ventricular fibrillation, cardiac arrest). To rule-out arrhythmia, we evaluated left ventricular ejection fraction (LVEF), maximal cardiac troponin-T (cTnT) levels and a multivariable model. Results: Among 304 patients with AM (41 ± 16.6 years, 27 % female), 13 life-threatening arrhythmias occurred in 10 (3.3 %) patients. Of these, 8 occurred within 24 h, 2 between 24–48 h and 3 after 72 h of hospitalization. Patients with life-threatening arrhythmia had substantially higher mortality rates (40 % vs. 0.3 %, p < 0.001). There was no binary cut-off for LVEF and cTnT to rule-out arrhythmia. The last life-threatening arrhythmia occurred before the cTnT-peak in 3 (42.9 %), simultaneously with the peak in 1 (14.3 %), and after the peak in 3 (42.9 %) patients. The final multivariable model included female sex, cTnT, and LVEF and demonstrated an area under the curve of 0.98 (95 % CI 0.96–1), with a sensitivity of 99 % and specificity of 75 % to rule-out life-threatening arrhythmia. Conclusions: In patients with suspected AM, life-threatening arrhythmias were rare but associated with a 40% mortality rate. A combined model including 3 clinical variables ruled-out life-threatening arrhythmia with a high sensitivity and may help to guide the indication of rhythm monitoring. |
| format | Article |
| id | doaj-art-a3e616e10a6a465b979b70fca2a9c41c |
| institution | Kabale University |
| issn | 2352-9067 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-a3e616e10a6a465b979b70fca2a9c41c2025-08-20T04:02:13ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672025-08-015910171810.1016/j.ijcha.2025.101718Life-threatening arrhythmia in patients with suspected acute myocarditisMelina Krempke0Jasmin Büchel1Kseniya Bulatova2Gianmarco M. Balestra3Philip Haaf4Jeanne Pouly5Paul Drews6Christian Mueller7Sven Knecht8Patrick Badertscher9Felix Mahfoud10Michael Kühne11Christian Sticherling12Philipp Krisai13Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandDepartment of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandCorresponding author at: Department of Cardiology, University Hospital Basel, Petersgraben 4, 4031 Basel, CH, Switzerland.; Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, SwitzerlandBackground: Patients with acute myocarditis (AM) often undergo prolonged rhythm monitoring due to the risk for life-threatening arrhythmia. Objective: To describe the occurrence, timing and potential early rule-out of life-threatening arrhythmia in patients with AM. Methods: We included consecutive patients with suspected AM admitted to the ICU/IMC for continuous rhythm monitoring into a cohort study. We assessed the incidence and timing of life-threatening arrhythmia (sustained ventricular tachycardia, ventricular fibrillation, cardiac arrest). To rule-out arrhythmia, we evaluated left ventricular ejection fraction (LVEF), maximal cardiac troponin-T (cTnT) levels and a multivariable model. Results: Among 304 patients with AM (41 ± 16.6 years, 27 % female), 13 life-threatening arrhythmias occurred in 10 (3.3 %) patients. Of these, 8 occurred within 24 h, 2 between 24–48 h and 3 after 72 h of hospitalization. Patients with life-threatening arrhythmia had substantially higher mortality rates (40 % vs. 0.3 %, p < 0.001). There was no binary cut-off for LVEF and cTnT to rule-out arrhythmia. The last life-threatening arrhythmia occurred before the cTnT-peak in 3 (42.9 %), simultaneously with the peak in 1 (14.3 %), and after the peak in 3 (42.9 %) patients. The final multivariable model included female sex, cTnT, and LVEF and demonstrated an area under the curve of 0.98 (95 % CI 0.96–1), with a sensitivity of 99 % and specificity of 75 % to rule-out life-threatening arrhythmia. Conclusions: In patients with suspected AM, life-threatening arrhythmias were rare but associated with a 40% mortality rate. A combined model including 3 clinical variables ruled-out life-threatening arrhythmia with a high sensitivity and may help to guide the indication of rhythm monitoring.http://www.sciencedirect.com/science/article/pii/S2352906725001216Acute MyocarditisArrhythmiaSustained ventricular tachycardiaVentricular fibrillationCardiac arrestTroponin |
| spellingShingle | Melina Krempke Jasmin Büchel Kseniya Bulatova Gianmarco M. Balestra Philip Haaf Jeanne Pouly Paul Drews Christian Mueller Sven Knecht Patrick Badertscher Felix Mahfoud Michael Kühne Christian Sticherling Philipp Krisai Life-threatening arrhythmia in patients with suspected acute myocarditis International Journal of Cardiology: Heart & Vasculature Acute Myocarditis Arrhythmia Sustained ventricular tachycardia Ventricular fibrillation Cardiac arrest Troponin |
| title | Life-threatening arrhythmia in patients with suspected acute myocarditis |
| title_full | Life-threatening arrhythmia in patients with suspected acute myocarditis |
| title_fullStr | Life-threatening arrhythmia in patients with suspected acute myocarditis |
| title_full_unstemmed | Life-threatening arrhythmia in patients with suspected acute myocarditis |
| title_short | Life-threatening arrhythmia in patients with suspected acute myocarditis |
| title_sort | life threatening arrhythmia in patients with suspected acute myocarditis |
| topic | Acute Myocarditis Arrhythmia Sustained ventricular tachycardia Ventricular fibrillation Cardiac arrest Troponin |
| url | http://www.sciencedirect.com/science/article/pii/S2352906725001216 |
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